The present invention relates generally to a medical information engine, and particularly to management and consolidation of medical information which enables analysis of patient referrals in a medical network for the purpose of optimizing referral practices.
Despite rapid growth of innovation in other fields in recent decades, the world of medical information, including patient medical records, billing, referrals, and a host of other information, has enjoyed little to no useful consolidation, reliability, or ease-of-access, leaving medical professionals, hospitals, clinics, and even insurance companies with many issues, such as unreliability of medical information, uncertainty of diagnosis, lack of standard, and a slew of other related problems.
One of the challenges facing those in the medical or related areas is the number of sources of information, the great amount of information from each source, and consolidation of such information in a manner that renders it meaningful and useful to those in the field in addition to patients. Obviously, this has contributed to increased medical costs and is perhaps largely attributed to the field suffering from an organized solution to better aid the medical professionals, to better aid those requiring more reliable patient history and those requiring more control and access over such information.
Currently, when a patient sees various medical professionals over the years, there is no method for universally tracking recommendations, thoughts, prescriptions, referrals, or diagnosis. This hinders the job of insurance companies in making certain requisite determinations, physicians making decisions that directly impact the health of the patient, and hospitals and other medical institutions that similarly rely but do not have the benefit of the requisite information, not to mention the patient.
For consolidated provider networks it may be possible to centralize a patient's records. However, these records are typically not available outside of the network, and moreover, often the records generated outside of network are often isolated. Patient referrals, thus can cause increased costs for an insurer, and may result in fragmented patient information. By being able to properly analyze patient referral practices, insurers and health managers would be more able to provide better referral service to patients, increase patient retention, and increase operational efficiency.
It is therefore apparent that an urgent need exists for a health information management system usable to those in the medical field, including patients. A functionality of such a system would be the ability to track patient referrals, and generate models which assist insurers and care providers to track referral practices. Such a system should also be capable of reconciling and intent-based clustering of patient data by applying at least one clustering rule to the reconciled medication information, and presenting the clustered reconciled medical information to a user.